Provider Demographics
NPI:1508401241
Name:VRC COUNSELING AGENCY, PLLC
Entity Type:Organization
Organization Name:VRC COUNSELING AGENCY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LPC
Authorized Official - Prefix:
Authorized Official - First Name:VANEKA
Authorized Official - Middle Name:ROCHELLE
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:910-489-9160
Mailing Address - Street 1:1545 KERSHAW LOOP
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-8905
Mailing Address - Country:US
Mailing Address - Phone:910-489-9160
Mailing Address - Fax:
Practice Address - Street 1:209 W ARMFIELD ST
Practice Address - Street 2:
Practice Address - City:SAINT PAULS
Practice Address - State:NC
Practice Address - Zip Code:28384-1521
Practice Address - Country:US
Practice Address - Phone:910-489-9160
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-15
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty